Social and behavior change communication (SBCC), often also only "BCC" or "Communication for Development (C4D)" is an interactive process of any intervention with individuals, group or community (as integrated with an overall program) to develop communication strategies to promote positive behaviors which are appropriate to their settings and thereby solving the world's most pressing health problems. This in turn provides a supportive environment which will enable people to initiate, sustain and maintain positive and desirable behavior outcomes. [1]
SBCC is the strategic use of communication to promote positive health outcomes, based on proven theories and models of behavior change. SBCC employs a systematic process beginning with formative research and behavior analysis, followed by communication planning, implementation, and monitoring and evaluation. Audiences are carefully segmented, messages and materials are pre-tested, and mass media (which include radio, television, billboards, print material, internet), interpersonal channels (such as client-provider interaction, group presentations) and community mobilisation are used to achieve defined behavioral objectives. [2]
BCC should not be confused with behavior modification, a term with specific meaning in a clinical psychiatry setting. SBCC differentiates itself from social impact entertainment primarily through its "impact first", rather than "story first", approach.
Providing people with information and teaching them how they should behave does not lead to desirable change in their response/behavior. However, when there is a supportive environment with information and communication (teaching) then there is a desirable change in the behavior of the target group. Thus, SBCC is proved to be an instructional intervention which has a close interface with education and communication. It is a strategic and group oriented form of communication to perceive a desired change in behavior of target group. [3]
However, it is not as easy as it sounds, as there is no one-size-fits all strategy for any intervention. Interventions are context specific. Therefore, there is a need for proper information management and sharing. It is advised to document and report the interventions that worked somewhere, for example, the kind of messages, the medium and the audience. [4]
SBCC is the comprehensive process in which one passes through the stages:
Unaware > Aware > Concerned > Knowledgeable > Motivated to change > Practicing trial behavior change
> Sustained behavior change
It involves the following steps: [5]
Behavior change is influenced by motivation from others (external influence) as well as from within oneself (internal influence). Internal influence plays a significant role in creating more enjoyment of a behavior change, instilling a sense of ownership of the new behavior, which in turn instills a sense of ownership of the changed behavior. [6] When designing SBCC strategies, enabling factors that affect the outcome must be considered. The following are some of the factors: [5]
SBCC has several levels at which it can be implemented. Each level includes several theories. Each level (and each theory) employs specific communication channels.
SBCC is different from the ordinary instructional method of communication and is target specific. A society consists of many sub-groups. The strategy for SBCC will vary from group to group. The following points are important while considering the SBCC strategy. [7]
There can be several more points in this list. A successful SBCC requires much research and meticulous planning about the knowledge content of the subject and behavior/attitude pattern of the target group. [1]
Social marketing has been described as a tool for sustainable behaviour change. [8]
SBCC has proven effective in several health areas, such as increasing the use of family planning methods, reducing the spread of malaria and other infectious diseases, and improving newborn and maternal health.
SBCC is an effective tool for dealing with many community and group related problems. BCC has been adapted as an effective strategy for community mobilization, health and environmental education and various public outreach programs. [9] Enhanced knowledge about the behavior change process has facilitated the design of communications programs to reduce the risk of HIV transmission and AIDS. A wide variety of health promotion strategies use communication as either an educational or norm-forming strategy. In addition, specific strategies must be designed for high-risk groups such as women, young people, injecting drug abusers, homosexuals and HIV positive groups. [7]
SBCC consists of effective communication which is central to the success of interventions to reduce the risk of HIV infection. It plays a role to: [7] [5]
Persuasive technology is broadly defined as technology that is designed to change attitudes or behaviors of the users through persuasion and social influence, but not necessarily through coercion. Such technologies are regularly used in sales, diplomacy, politics, religion, military training, public health, and management, and may potentially be used in any area of human-human or human-computer interaction. Most self-identified persuasive technology research focuses on interactive, computational technologies, including desktop computers, Internet services, video games, and mobile devices, but this incorporates and builds on the results, theories, and methods of experimental psychology, rhetoric, and human-computer interaction. The design of persuasive technologies can be seen as a particular case of design with intent.
Antisocial behaviours are actions which are considered to violate the rights of or otherwise harm others by committing crime or nuisance, such as stealing and physical attack or noncriminal behaviours such as lying and manipulation. It is considered to be disruptive to others in society. This can be carried out in various ways, which includes, but is not limited to, intentional aggression, as well as covert and overt hostility. Anti-social behaviour also develops through social interaction within the family and community. It continuously affects a child's temperament, cognitive ability and their involvement with negative peers, dramatically affecting children's cooperative problem-solving skills. Many people also label behaviour which is deemed contrary to prevailing norms for social conduct as anti-social behaviour. However, researchers have stated that it is a difficult term to define, particularly in the United Kingdom where many acts fall into its category. The term is especially used in British English.
Development communication refers to the use of communication to facilitate social development. Development communication engages stakeholders and policy makers, establishes conducive environments, assesses risks and opportunities and promotes information exchange to create positive social change via sustainable development. Development communication techniques include information dissemination and education, behavior change, social marketing, social mobilization, media advocacy, communication for social change, and community participation.
Behavior change, in context of public health, refers to efforts put in place to change people's personal habits and attitudes, to prevent disease. Behavior change in public health can take place at several levels and is known as social and behavior change (SBC). More and more, efforts focus on prevention of disease to save healthcare care costs. This is particularly important in low and middle income countries, where supply side health interventions have come under increased scrutiny because of the cost.
The transtheoretical model of behavior change is an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual. The model is composed of constructs such as: stages of change, processes of change, levels of change, self-efficacy, and decisional balance.
Social marketing is a marketing approach which focuses on influencing behavior with the primary goal of achieving "common good." It utilizes the elements of commercial marketing and applies them to social concepts. However, to see social marketing as only the use of standard commercial marketing practices to achieve non-commercial goals is an oversimplified view. Social marketing has existed for some time, but has only started becoming a common term in recent decades. It was originally done using newspapers and billboards and has adapted to the modern world in many of the same ways commercial marketing has. The most common use of social marketing in today's society is through social media.
The social norms approach, or social norms marketing, is an environmental strategy gaining ground in health campaigns. While conducting research in the mid-1980s, two researchers, H.W. Perkins and A.D. Berkowitz, reported that students at a small U.S. college held exaggerated beliefs about the normal frequency and consumption habits of other students with regard to alcohol. These inflated perceptions have been found in many educational institutions, with varying populations and locations. Despite the fact that college drinking is at elevated levels, the perceived amount almost always exceeds actual behavior. The social norms approach has shown signs of countering misperceptions, however research on changes in behavior resulting from changed perceptions varies between mixed to conclusively nonexistent.
Motivational interviewing (MI) is a counseling approach developed in part by clinical psychologists William R. Miller and Stephen Rollnick. It is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, it is more focused and goal-directed, and departs from traditional Rogerian client-centered therapy through this use of direction, in which therapists attempt to influence clients to consider making changes, rather than engaging in non-directive therapeutic exploration. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal. MI is most centrally defined not by technique but by its spirit as a facilitative style for interpersonal relationship.
Communities That Care (CTC) is a program of the Center for Substance Abuse Prevention (CSAP) in the office of the United States Government's Substance Abuse and Mental Health Services Administration (SAMHSA). CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school drop out and substance abuse. Using strategic consultation, training, and research-based tools, CTC is designed to help community stakeholders and decision makers understand and apply information about risk and protective factors, and programs that are proven to make a difference in promoting healthy youth development, in order to most effectively address the specific issues facing their community's youth.
Health communication is the study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient. The purpose of disseminating health information is to influence personal health choices by improving health literacy. Health communication is a unique niche in healthcare that allows professionals to use communication strategies to inform and influence decisions and actions of the public to improve health.
Peer education is an approach to health promotion, in which community members are supported to promote health-enhancing change among their peers. Peer education is the teaching or sharing of health information, values and behavior in educating others who may share similar social backgrounds or life experiences.
Audience segmentation is a process of dividing people into homogeneous subgroups based upon defined criterion such as product usage, demographics, psychographics, communication behaviors and media use. Audience segmentation is used in commercial marketing so advertisers can design and tailor products and services that satisfy the targeted groups. In social marketing, audiences are segmented into subgroups and assumed to have similar interests, needs and behavioral patterns and this assumption allows social marketers to design relevant health or social messages that influence the people to adopt recommended behaviors. Audience segmentation is widely accepted as a fundamental strategy in communication campaigns to influence health and social change. Audience segmentation makes campaign efforts more effective when messages are tailored to the distinct subgroups and more efficient when the target audience is selected based on their susceptibility and receptivity.
The PRECEDE–PROCEED model is a cost–benefit evaluation framework proposed in 1974 by Lawrence W. Green that can help health program planners, policy makers and other evaluators, analyze situations and design health programs efficiently. It provides a comprehensive structure for assessing health and quality of life needs, and for designing, implementing and evaluating health promotion and other public health programs to meet those needs. One purpose and guiding principle of the PRECEDE–PROCEED model is to direct initial attention to outcomes, rather than inputs. It guides planners through a process that starts with desired outcomes and then works backwards in the causal chain to identify a mix of strategies for achieving those objectives. A fundamental assumption of the model is the active participation of its intended audience — that is, that the participants ("consumers") will take an active part in defining their own problems, establishing their goals and developing their solutions.
A behavior change method, or behavior change technique, is a theory-based method for changing one or several determinants of behavior such as a person's attitude or self-efficacy. Such behavior change methods are used in behavior change interventions. Although of course attempts to influence people's attitude and other psychological determinants were much older, especially the definition developed in the late nineties yielded useful insights, in particular four important benefits:
Founded in 1999, Alliance India is a non-governmental organisation operating in partnership with civil society, government and communities to support sustained responses to HIV in India that protect rights and improve health. Complementing the Indian national programme, we build capacity, provide technical support and advocate to strengthen the delivery of effective, innovative, community-based HIV programmes to vulnerable populations: sex workers, men who have sex with men (MSM), transgender people, hijras, people who inject drugs (PWID), and people living with HIV.
A health campaign is a type of media campaign which attempts to promote public health by making new health interventions available. The organizers of a health campaign frequently use education along with an opportunity to participate further, such as when a vaccination campaign seeks both to educate the public about a vaccine and provide the vaccine to people who want it. When a health campaign has international relevance it may be called a global health campaign.
Barrier Analysis is a rapid assessment tool used in behavior change projects. The purpose of Barrier Analysis is to identify behavioral determinants of a particular behaviour so that more effective social and behavioral change messages, strategies, and supporting activities can be developed. Barrier Analysis is a relatively easy to use approach that can be conducted in a short period of time, allowing implementers to quickly make decisions based on the findings. This method has been used in 39 organizations and agencies in 59 countries. The training manual is available in English, Spanish, French, and Arabic.
Behavioural design is a sub-category of design, which is concerned with how design can shape, or be used to influence human behaviour. All approaches of design for behaviour change acknowledge that artifacts have an important influence on human behaviour and/or behavioural decisions. They strongly draw on theories of behavioural change, including the division into personal, behavioural, and environmental characteristics as drivers for behaviour change. Areas in which design for behaviour change has been most commonly applied include health and wellbeing, sustainability, safety and social context, as well as crime prevention.
The Transgender HIV/Aids Prevention Program was launched by The Department of Family Practice and The Community Health Medical School at the University of Minnesota in 1992. The program targeted the local transgender community. It was estimated that in 1992 up to 17,000 people were HIV-antibody positive in the state of Minnesota. The organizers realized that there was a lack of knowledge and attitudinal barriers towards HIV prevention among transvestites and transsexuals. This knowledge deficit among the transgender community coupled with the steadily increasing number of people affected with HIV/AIDS at the time catalyzed the formation of the Transgender HIV Aids Prevention Program at the University of Minnesota.
A Behavioral Change Support System (BCSS) is any information and communications technology (ICT) tool, web platform, or gamified environment which targets behavioral changes in its end-users. BCSS are built upon persuasive systems design techniques.